Anticonvulsant (Carbamazepine) dose and use in pregnancy

Usual Adult Dose for Epilepsy

Initial dose: 200 mg orally twice a day (immediate and extended release) or 100 mg orally 4 times a day (suspension).
Increase dose at weekly intervals in 200 mg/day increments using a twice daily regimen of extended release or a three times a day or four times a day regimen of the other formulations.
Maintenance dose: 800 to 1200 mg/day.
Dosage generally should not exceed 1200 mg/day.
However, doses up to 1600 mg/day have been used in rare instances.

Usual Adult Dose for Trigeminal Neuralgia

Initial dose: 100 mg orally twice a day (immediate or extended release) or 50 mg orally 4 times a day (suspension).
May increase by up to 200 mg/day using increments of 100 mg every 12 hours (immediate or extended release), or 50 mg four times a day. (suspension), only as needed to achieve freedom from pain. Do not exceed 1200 mg/ day.
Maintenance dose: 400 to 800 mg/day.
Some patients may be maintained on as little as 200 mg/day while others may require as much as 1200 mg/day. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level or to discontinue the drug.

Usual Adult Dose for Bipolar Disorder

Initial dose: 200 mg orally in tablet or capsule form every 12 hours or 100 mg of oral solution 4 times a day.

Tablets and solution:
Following autoinduction, higher doses will be necessary to maintain drug levels within the therapeutic range of 6 to 12 mcg/mL. The daily dose should be increased in 100 to 200 mg increments at 1 to 2 week intervals.

Maintenance dose: up to 1200 mg daily in 3 or 4 divided doses may be necessary to maintain plasma levels in the therapeutic range.

Extended release capsules:
The dose should be adjusted in 200 mg daily increments (increase by 100 mg twice daily) to achieve optimal clinical response. Doses higher than 1600 mg per day have not been studied.

Usual Adult Dose for Diabetic Neuropathy

Initial dose: 100 mg orally in tablet form every 12 hours or 50 mg of oral solution 4 times a day.

The daily dose should be increased in 100 mg increments at 1 to 2 week intervals.

Maintenance dose: 600 to 1200 mg daily in 3 or 4 divided doses may be necessary to maintain plasma levels in the therapeutic range.

Posted by Unknown 10:19 PM 2 comments

Anticonvulsant Carbamazepine Use indication

Trade Name: carbazine,valex,valex CR,Tegretol CR

Carbamazepine

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain.
Carbamazepine is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. It is also used to treat bipolar disorder.
Carbamazepine may also be used for purposes not listed in this medication guide.

Important information

You should not take carbamazepine if you have a history of bone marrow suppression, if you are also taking nefazodone, or if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).
Treatment for bipolar disorder is getting better every day and there are things you can start doing right away.
This medication may cause severe or life-threatening skin rash. Your doctor may recommend a blood test before you start the medication to determine your risk.
Do not start or stop taking carbamazepine during pregnancy without your doctor's advice. Carbamazepine may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking carbamazepine for seizures.
TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make carbamazepine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

When taking carbamazepine

Do not use carbamazepine if you also take nefazodone, or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.
You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), doxepin (Sinequan, Silenor), imipramine (Tofranil), or nortriptyline (Pamelor).
Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.
To make sure carbamazepine is safe for you, tell your doctor if you have any of these conditions:

·         heart disease, high blood pressure, high cholesterol or triglycerides;

·         liver or kidney disease;

·         glaucoma;

·         a thyroid disorder;

·         lupus;

·         porphyria; or

·         a history of mental illness, psychosis, or suicidal thoughts or actions.

You may have thoughts about suicide while taking carbamazepine. Tell your doctor if you have symptoms of depression or suicidal thoughts. Your family or other caregivers should also be alert to changes in your mood or symptoms.
FDA pregnancy category D. Do not start or stop taking carbamazepine during pregnancy without your doctor's advice. Carbamazepine may cause harm to an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking carbamazepine for seizures. Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) to prevent pregnancy while taking this medicine.
Carbamazepine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.

How should I Use carbamazepine?

Take carbamazepine exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.
Do not crush, chew, break, or open a carbamazepine extended-release tablet or capsule. Swallow the pill whole. Breaking the pill would cause too much of the drug to be released at one time.
You may open the extended-release capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow right away without chewing. Do not save the mixture for later use. Discard the empty capsule.
Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
The chewable tablet must be chewed before you swallow it.
It may take up to 4 weeks before your symptoms improve. Keep using carbamazepine as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.
While using carbamazepine, you may need frequent blood tests at your doctor's office.
Do not stop using carbamazepine without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using carbamazepine suddenly.
Store carbamazepine at room temperature away from moisture, heat, and light.

Posted by Unknown 10:11 PM 0 comments